Beyond the cadaver: evaluating virtual reality simulation for modern otolaryngology surgical training

Abstract Virtual Reality (VR) simulation is increasingly being adopted as a potential revolutionary technology in surgical education, providing the ability to offer an immersive, reproducible, and safe setting in which to teach procedures. In otolaryngology, a clinically demanding field that relies on detailed anatomic understanding and fine motor skills, VR has the potential to address the limitations of traditional training models based on a lack of access to cadaveric material, decreased operative exposure, and increased patient safety concerns. This article provides a critical review of the available publications concerning the role of VR in ENT surgery training. The present review included 14 pivotal studies, e.g., systematic reviews, controlled trials, comparative performance, and expert analyses. The findings suggest that VR simulation platforms may be exhibiting construct, face, and content validity, especially those in temporal bone and endoscopic sinus surgical practice. A number of studies demonstrate that VR-trained participants achieve statistically significant skill acquisition, error reduction, levels of confidence, and reductions in task completion time, comparing favorably to control groups. Additional studies report that trainees are more motivated and interested in pursuing ENT specialities after benefiting from VR. Despite these advantages, limitations exist. Simulations are not all tested for advanced procedures, and there are limited data associating VR training with long-lasting competence in surgery or patient outcomes. Cost, hardware ability, and lack of universal assessment metrics are further obstacles to the universality of such a system.